A superbug, which can be fatal, is spreading in the province’s hospitals, and the Haut-Richelieu Hospital is no exception. The Integrated Health and Social Services Center (CISSS) of Montérégie-Centre has not reported any cases of infection with the BGNPC bacteria (gram-negative bacilli producing carbapenemase). However, there is an outbreak in progress since there are two cases of colonization of this bacteria, that is to say that two people are carriers without having developed symptoms or infected other patients.
A BGNPC outbreak is declared when there are two or more cases of colonization (or infection) at the same time. “We had an outbreak of colonized cases, that is to say people who were not sick with this bacteria, but the bacteria was found in their stools; cases of carriers,” explains Dr. Amélie Thuot, microbiologist at the CISSS de la Montérégie-Centre.
Identified at the end of December, this outbreak is the first of its kind at the Haut-Richelieu Hospital. Patients carrying this bacteria had already stayed in hospital in recent years, without leading to outbreaks. These two cases of colonized patients were the first in 2024. In 2023, no cases of colonization had been reported in Haut-Richelieu. Since the discovery of the BGNPC bacteria in the early 2000s, no infection has occurred at the Haut-Richelieu Hospital.
The bacteria
Gram-negative bacilli (GNB) bacteria are naturally present in the digestive system. However, in a person with a weakened immune system or serious medical problems, they can cause serious infections.
Transmission occurs in health care establishments during a short or long stay, according to the Government of Canada. The Quebec University Hospital specifies that the bacteria is transmitted in different ways: through the hands of healthcare personnel, through contaminated healthcare equipment, or through contact with taps.
Some of these BGN bacteria have, over time, developed resistance to antibiotics: we then speak of BGNPC. When infected with BGNPC, it is even more difficult to resolve the infection, since the bacteria is resistant to more general antibiotics. In a file published on December 28, The Press reported that 1,259 people had been colonized by the BGNPC bacteria in 2023-2024 in Quebec. Of these, 99 people were infected; Thirteen of these people died.
Prevention
Given the ineffectiveness of antibiotics against BGNPC bacteria, prevention is better than cure. Since 2018, the National Institute of Public Health of Quebec (INSPQ) has imposed a protocol on hospitals in the event of detection of BGNPC carriers and in the event of infection.
-Screening is the watchword. Patients at risk, who have been hospitalized for more than 24 hours outside of Quebec in the last year or who have stayed more than 24 hours in a Quebec establishment where there is an active infection, for example, are screened upon their arrival at the hospital. If a case is detected, patients in the unit where the carrier is staying must in turn be screened.
Since the bacteria is transmitted by contact, “environmental disinfection is important and respecting hygiene measures too, such as washing your hands well,” recalls Dr. Thuot.
Antibiotic resistance
Although the situation is not yet serious in Saint-Jean, the microbiologist maintains that “the incidence is slowly increasing”, here as elsewhere. The BGNPC bacteria has been identified in two-thirds of Quebec hospitals in 2024.
“These are bacteria that have become resistant to the class called carbapenems, and therefore have developed mutations that have given them resistance genes to carbapenems, which are very broad antibiotics,” explains Dr. Thuot. We use them when there are severe infections. »
Since the invention of antibiotics with penicillin, around 100 years ago, mutations in bacteria have been observed in response to the drug. “It’s a bit of an escalation: we give an antibiotic, the bacteria mutate, and this bacteria becomes resistant [à l’antibiotique]. The time that [la mutation} se dissémine mondialement, ce qui prend quelques années, l’industrie pharmaceutique développe une autre sorte d’antibiotique, et ainsi de suite », illustre la Dre Amélie Thuot.
Or, la classe des carbapénèmes devait être le « gros canon » du monde médical, selon la microbiologiste. Plus fort que bien d’autres antibiotiques, on comptait sur son efficacité à long terme. « On n’a plus tant d’autres sortes d’antibiotiques », s’inquiète-t-elle.
